The latest COVID-19 variant, Omicron, is raising new fears—among policymakers, parents, educators, business owners and, well, just about everyone. It is transmissible, and this may be a good thing. Initial reports show it to be significantly more transmittable than the previous COVID-19 variants. But for those of us engaged in clinical care and public health—we’re an emergency physician and trauma surgeon—there’s a different fear: with almost every part of our system already overtaxed, we are on the verge of a collapse that will leave us unable to provide even a basic standard of care. Omicron may prove mild in the end, but it can be the final straw.
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American healthcare had been stretched before the outbreak of the pandemic. Over the past two years, this problem has only grown worse. Healthcare facilities have been suffering from severe shortages in resources. This includes basic medicines, operating room staff and cooks to be able to provide care for patients. They are all vital for providing high-quality, compassionate care to patients with trauma, critical ill diabetes, and patients with severe behavioral problems.
These shortages can be attributed to many factors.
The breakdown in our supply chain—the same factors slowing the shipping of microchips and holiday gifts—is part of it. Another factor is a lack of funds, which can be especially problematic for small and rural healthcare providers. To ensure there were sufficient nurses, beds and ventilators for COVID-19, elective surgeries were cancelled early in the pandemic. This was a crucial decision to save lives. However, most healthcare relies on revenue from surgery to pay for other services. Budgets are already stretched by the increasing cost of temporary contract labor. Also, personal protection equipment cost more than ever. The Great Resignation—the dramatic drop-off of people in the workplace—is another.
Healthcare staff shortages can be a sign of more. (Vaccine mandates do not cause shortages. In Rhode Island for instance, two of the largest healthcare systems kept more than 95% of their staff, while other larger systems retained much more.
This is due to the fact that doctors, nurses and technicians have just had enough. They are now leaving after 20 months of fighting the virus and managing overflowing patient cases. We are still paying more for those who have remained, but it may not suffice to ensure that staff standards remain safe. We don’t have any healthcare workers without them.
Many hospitals now have to stop elective and surgical procedures. It isn’t because COVID-19 has caused a surge in patients, but simply because the beds or staff are not sufficient. Even without a massive surge in patients with COVID-19, when we can’t transfer patients out of the hospital into a nursing home, the hospital beds stay full; when hospital bed are full, patients can’t be admitted from the emergency department; and when patients can’t be admitted, emergency departments’ waiting rooms and primary care offices fill up with untreated acute problems. Nurses and doctors are frustrated that they can’t provide timely care, and patients and families are angry at the waits. Everybody is affected, even in the short term.
These cancellations can cause a series of devastating systemic reactions that will continue to hurt long after the procedure is cancelled. The people whose surgeries are being cancelled really need them—it’s not cosmetic surgery, but people suffering from conditions like gallbladder disease or people who need a colonoscopy. They will either be left with a chronic condition or they may continue flooding emergency rooms with unnecessary procedures. Further down the road, the continued cancellations will further hurt hospitals’ ability to pay for core functions, and may lead to the closure of units within hospitals or even whole hospitals.
For those of us on the front line, it feels like a game of Whac-A-Mole in which we are no longer able to react fast enough to the “moles” popping up.
All of this is happening while Omicron is just arriving on our shores. We are still gathering data that will help us to respond to the future.
Learn More What It’s Like to Be a Healthcare Worker During COVID-19 Pandemic
Already, the pandemic has decimated many communities and worsened existing health inequalities, proving how important it is to be prepared for public health emergencies. As we watch the number of public health emergencies like opioid overdoses and firearm injuries, as well as other issues, such things are on the rise. And our fractured health care system is facing huge stress as we lose the one remaining piece that has been the glue holding us together for so long—healthcare workers. Healthcare workers are available 24 hours a day, 7 days a week, weekends and holidays. They sacrifice so much to support others in their most vulnerable times. That’s our job, and we are proud to do it. We cannot ignore the immense impact this pandemic had on the lives of our colleagues. It is imperative that we act immediately if we are to save any lives.
We must keep pushing for testing and vaccinations. But in the meantime, let’s look around. The hospitals are empty of anything to offer. If we are to avoid a descent into crisis standards of care, it’s time to shore up our hospitals and clinics.
We would encourage the government to help us invest in both increasing the healthcare workforce pipeline and supporting adequate pay for nurses, advanced practitioners, technicians, home healthcare aides, and all the other ancillary staff; bolster our remaining staff, in the short-term, through on-the-ground civil-military cooperation; consider the deployment of healthcare professionals within the U.S. Public Health Commissioned Corps to reinforce clinics, nursing homes, and other critical healthcare functions; and make real commitments, both monetary and otherwise, to supporting our public health preparedness and prevention systems, so we don’t end up in a worse place than we are right now. Supporting the mental health of frontline workers is more than simply taking COVID-19 measures.
Although no one expects to get sick or injured, it is something that most people want to do. Of course, we want to support you. We need your help to make this possible.
